Comparison of the Outcome of Extremely-Low-Birth-Weight Infants between Two Periods

比較兩時期間極低體重兒的預後

曹伯年(Po-Nien Tsao) ； 吳宗瑾(Tzong-Jin Wu) ； 滕儒錚(Ru-Jeng Teng) ； 唐禎瑞(Jen-Ruey Tang) ； 鄒國英(Kuo-Inn Tsou Yau)

《Acta Paediatrica Sinica》 39卷4期 (1998/08) Pp. 233-236

https://doi.org/10.7097/APS.199808.0233

摘要

我們比較了台大醫院自1993年到1996年4年間（第二期）72個和1988年到1992年5年間（第一期）22個極低體重兒的預後。若有父母拒絕急救，或胎兒有先天性重大異常的病例則不列入其中。極低體重兒的發生率在第一、二期分別爲23/10173(0.23%)、81/13835(0.59%)。結果，在第二期的早期新生兒死亡率明顯的降低了。存活的臨界點出由原先的懷孕26週或出生體重700公克進步到懷孕24週或出生體重600公克。不過，在新生兒罹病率及死亡率並沒有明顯的進步。從這篇研究我們可以得知，經由外在肺泡表面張力素的廣泛使用及現代新生兒照顧的進步，使得早期新生兒存活率及存活的臨界點都有明顯的改善。

關鍵字

極低體重兒 ； 死亡率 ； 罹病率 ； 表面張力素

並列摘要

A comparison was made of the outcome of 73 neonates born with their birth weight of 500-999gm in National Taiwan University Hospital during the period between January 1, 1993 and December 31, 1996 (PeriodⅡ), with the outcome of 21 such neonates born between April 1, 1988 and October 31, 1992 (Period Ⅰ). Exclusion criteria included parental refusal for resuscitation, and major anomalies. Data were collected via a predetermined record sheet. The incidences of the extremely-low-birth-weight infants were 23/10,173 (0.23%) and 81/13,835 (0.59%) in Periods I and Ⅱ, respectively. Early neonatal mortality rate was significant decreased in Period II (43% versus 14%). The limit of viability was improved from gestational age of 26 weeks or 700gm to gestational age of 24 weeks or 600gm. The incidence of neonatal morbidity (80% versus 50%) and total survival rate (48% versus 60%) have not changed significantly as seen in this limited number of cases. This study concluded that, with the introduction of exogenous surfactant and modern neonatal care, early neonatal survival rate and the limit of viability were improved.

並列關鍵字

extremely-low-birth-weight ； mortality ； morbidity ； surfactant